Provider Demographics
NPI:1003810052
Name:THEILER, ANTHONY C (MD)
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:C
Last Name:THEILER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10250 N 92ND ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-4510
Mailing Address - Country:US
Mailing Address - Phone:480-237-5727
Mailing Address - Fax:480-657-3207
Practice Address - Street 1:10250 N 92ND ST
Practice Address - Street 2:SUITE 202
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4510
Practice Address - Country:US
Practice Address - Phone:480-237-5727
Practice Address - Fax:480-657-3207
Is Sole Proprietor?:No
Enumeration Date:2005-06-08
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ24072207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
G13651Medicare UPIN
WDCG502Medicare ID - Type Unspecified